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Individual

KATHRYN J LUBBEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 933-2113
(630) 933-4520
Mailing address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 933-2113
(630) 933-4520

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209.003981
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
206147
MEDICARE PTAN (GROUP)
IL
01
F400150056
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
06/04/2008
Last updated
07/21/2014
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